Fallows LK. The accountant joins the executive. Neurology (views and reviews) 2007; 68:991-995.
VM frontal lobes encode value that impacts decision making. It assesses factors such as risk, delay and ambiguity. The Iowa Card test shows impairment of decision making in patients with lesions in this area. VMF is impaired to behavior adjustment when payoffs to choices change. Whereas nucleus accumbens is critical for the magnitude of reward, the VMF is for whether the event will occur. VMF is required for experience of regret. VMF lesioned patients show disappointment over a sad outcome, but not autonomic changes, SCR's, and "maximizing" strategies investing more time and effort in establishing an outcome. Thus impulsive choices may not be risk-seeking, but lack of risk aversion.